Medication-Related Challenges in Lower Middle-Income Countries of Asia: A Review of Four Countries and Recommendations for Improvement

Background: It has been estimated that more than half of all medicines over the world are prescribed, dispensed or sold inappropriately. Objectives: This review aims to describe medication-related challenges in four lower Middle-Income Countries (LMIC) of Asia. Methods: A review of electronic databases such as google scholar, ScienceDirect and PubMed was performed to identify studies related to medication safety in LMIC. Results: The study results revealed that there is a lack of medication safety literature in most of the countries. Available literature reported that the prevalence of medication errors is very high, medications are dispensed by pharmacy technicians, hospital pharmacy services are offered only in contemporary hospitals and hospital drug information services are not widely implemented and there is a lack of e-health implementation. Among medication errors, unclear handwriting due to paper prescribing and incomplete prescription were common. Majority of medication errors and Adverse Drug events were unreported due to punitive culture, fear of litigation, lack of support from hospital management and incapacity to detect adverse events. Conclusion: Medication safety is a major challenge facing LMIC. This study recommended several strategies to improve medication-related challenges in LMIC.